Introducing Risperidone for Treatment of Schizophrenia to the Essential Drug List in Uganda: A Budget Impact Analysis

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Objectives The aim of this study was to analyze the budget impact of introducing risperidone onto the essential drug list for treating schizophrenia in Uganda. Risperidone is a second-generation antipsychotic that has been shown to be cost-effective in a previous study in Uganda. More information on its potential budget impact is needed. Methods Budget impact analysis was used to estimate the potential cost of risperidone from the payer perspective. Data on the epidemiology of schizophrenia, drug cost, treatment effect of antipsychotics, adverse effect of antipsychotics, and prescription pattern of antipsychotics were collected from published studies, the international drug price indicator guide, and clinical trial results. Results For treating 120,256 schizophrenia patients in Uganda in 2016, we calculated that the government would spend a total of $3,083,310 for chlorpromazine with an 80% market share and haloperidol with a 20% market share. Considering an annual increase of 10% market share for risperidone, the total budget would initially rise to $6,530,104 in 2017 and then level off to approximately $6 million from 2018 onward. The cost per tax payer per year ranges from $0.08 in 2016 to $0.14 in 2020 depending on different sets of market shares of the three antipsychotics. Conclusion As the price for risperidone falls and less adverse effects occur due to risperidone substitution, the total budget of adding risperidone to the essential drug list is expected to rise initially and then level off. As a result, it is recommended that risperidone be added onto the essential drug list considering its cost-effectiveness and potential affordability.